Physician career management: organizational strategies for the 21st century.

Burnout is a state of physical, emotional, and mental exhaustion caused by long-term involvement in situations that are emotionally demanding. It is not stress, per se, that causes burnout, as many thrive in stressful, demanding careers. Rather, burnout results when stress continuously outweighs the sense of effectiveness, accomplishment, and reward. And, this fate is sealed when one feels helpless to effect significant change in the conditions that fuel the stress. Establishing an organizational environment that reduces the risk of physician burnout requires a new commitment of resources, one that can be challenging to justify to decision-makers with a strictly short-term, bottom line orientation. The key issues to consider in shaping a physician career management program include: (1) entry of new physician employees into the organization; (2) productivity measures; (3) responsiveness to safety concerns; (4) administrative and policy issues; and (5) variety and growth opportunities.